NPI | 1699027128 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006905) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA030884) |
Enumeration Date | 2012-10-08 |
Last Update Date | 2019-12-19 |